AUDIOMETRY Pure tone air conduction audiometric threshold testing was conducted on all examinees aged 6-19 years by a trained examiner in a soundproof room in the mobile examination center (MEC). Before threshold testing, a screening questionnaire was administered to determine the need for test exclusions and to assess factors that might affect test results. Examinees who reported having ear drainage (AUPA10) were excluded from air conduction testing on the ear(s) with drainage. Because this examination was administered in the mobile examination center, the MEC examination sample weight (WTPFEX6) should be used for data analysis. For more information on the use of sample weights in NHANES III data analysis, refer to the NHANES III Analytic and Reporting Guidelines (U.S. DHHS, 1996b). Threshold testing was conducted on both ears of examinees at seven frequencies (500, 1000, 2000, 3000, 4000, 6000, and 8000 Hertz (Hz)). The valid range for air conduction threshold values was determined by the effective range of the audiometers (Grason-Stadler, Inc., Model GSI 16, Littleton, MA), which was from -20 to 105 dumbbells (dB). Observed values were between -10 and 100 dB. If an examinee did not respond to the signal tone at any level for one or more frequencies and a comment by the examiner indicated known deafness or severe hearing loss, a threshold level of 105 dB was entered. In accordance with the testing protocol, a retest with masking occurred if an examinee had air conduction threshold value(s) at a given frequency that differed by 40 dB or more between both ears. If the lack of response was unilateral with a threshold value of 65 dB or lower for the other ear, a threshold value of 105 dB was entered for the relevant retest with masking value(s). Before the examinations began at each MEC site, a field output calibration check was performed, and an environmental noise survey was conducted. The audiometer was rechecked weekly, and during examination periods, the tone quality, masking tone quality, hearing level controls, and earphones were checked daily. If a unit did not meet specifications, it was sent for service, and a backup unit was used for examinations. Additionally, laboratory calibration on each unit was performed approximately twice a year. For details of these procedures, analysts should consult the Audiometry and Tympanometry Manual (U.S. DHHS, 1996b). Air conduction threshold testing alone is not sufficient to fully characterize hearing loss; it only provides information on the severity and the frequencies affected. Because of this, tympanic membrane compliance also was measured to help determine the nature of any hearing loss observed in the audiometry data. Analysts should refer to the Tympanometry section of the Examination Data File for information on this aspect of hearing testing. In addition, questions on hearing status including ear infection history and the use of hearing aids can be found in the Household Youth Data File (2 months- 16 years of age). The audiometry consultant provided extensive training to examiners at their time of hire, and each examiner's performance was monitored on a periodic basis. Audiometry and tympanometry were priority components at three of four annual MEC team retrainings. Data processing and editing were performed to ensure internal data consistency. Notes have been provided for variables requiring additional explanation. NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ CONDITIONS AFFECTING TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3059 Have you had a cold or sinus problem AUPA1 within the past week? 1616 1 Yes 4622 2 No 259 8 Blank but applicable 24814 Blank 3060 Do you have a cold or sinus problem AUPA2 today? 962 1 Yes 653 2 No 260 8 Blank but applicable 29436 Blank 3061 Have you been exposed to a very loud AUPA3 noise within the past 24 hours? 354 1 Yes 5885 2 No 258 8 Blank but applicable 24814 Blank 3062-3063 How many hours ago did the noise end? AUPA4 337 01-24 11 77 Less than 1 hour 264 88 Blank but applicable 30699 Blank 3064 Have you listened to music with AUPA5 headphones/earphones in the past 24 hours? 621 1 Yes 5616 2 No 260 8 Blank but applicable 24814 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ CONDITIONS AFFECTING TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3065-3066 How many hours ago did you stop AUPA6 listening? 578 01-24 32 77 Less than 1 hour 271 88 Blank but applicable 30430 Blank 3067 Have you had buzzing/ringing or other AUPA7 noises in your ears today? 6048 2 No 64 3 Right 43 4 Left 82 5 Both 260 8 Blank but applicable 24814 Blank 3068 Have you had an earache within the past AUPA8 week? 5989 2 No 99 3 Right 91 4 Left 56 5 Both 262 8 Blank but applicable 24814 Blank 3069 Do you now have a tube in your right or See note AUPA9 left ear? 6152 2 No 9 3 Right 11 4 Left 56 5 Both 269 8 Blank but applicable 24814 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ CONDITIONS AFFECTING TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3070 Do you now have drainage/discharge from See note AUPA10 either ear? 6194 2 No 15 3 Right 13 4 Left 16 5 Both 259 8 Blank but applicable 24814 Blank 3071-3074 Audiometer number AUPAUDO1 660 1230 930 1237 856 1240 1174 1580 503 1581 965 2048 1153 2050 240 8888 Blank but applicable 24830 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ LEFT EAR TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3075-3077 Left ear air conduction hearing level, AUPB1A1 first test at 1000 Hz (dB) 6213 -10-105 255 888 Blank but applicable 24843 Blank 3078-3080 Left ear air conduction hearing level, AUPB1A2 2000 Hz (dB) 6208 -10-105 260 888 Blank but applicable 24843 Blank 3081-3083 Left ear air conduction hearing level, AUPB1A3 3000 Hz (dB) 6206 -10-105 262 888 Blank but applicable 24843 Blank 3084-3086 Left ear air conduction hearing level, AUPB1A4 4000 Hz (dB) 6203 -10-105 265 888 Blank but applicable 24843 Blank 3087-3089 Left ear air conduction hearing level, AUPB1A5 6000 Hz (dB) 6202 -10-105 266 888 Blank but applicable 24843 Blank 3090-3092 Left ear air conduction hearing level, AUPB1A6 8000 Hz (dB) 6199 -10-105 269 888 Blank but applicable 24843 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ LEFT EAR TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3093-3095 Left ear air conduction hearing level, AUPB1A7 repeat test at 1000 Hz (dB) 6197 -10-105 271 888 Blank but applicable 24843 Blank 3096-3098 Left ear air conduction hearing level, AUPB1A8 500 Hz (dB) 6196 -10-105 272 888 Blank but applicable 24843 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ RIGHT EAR TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3099-3101 Right ear air conduction hearing level, AUPB2A1 first test at 1000 Hz (dB) 6214 -10-105 252 888 Blank but applicable 24845 Blank 3102-3104 Right ear air conduction hearing level, AUPB2A2 2000 Hz (dB) 6213 -10-105 253 888 Blank but applicable 24845 Blank 3105-3107 Right ear air conduction hearing level, AUPB2A3 3000 Hz (dB) 6207 -10-105 259 888 Blank but applicable 24845 Blank 3108-3110 Right ear air conduction hearing level, AUPB2A4 4000 Hz (dB) 6204 -10-105 262 888 Blank but applicable 24845 Blank 3111-3113 Right ear air conduction hearing level, AUPB2A5 6000 Hz (dB) 6198 -10-105 268 888 Blank but applicable 24845 Blank 3114-3116 Right ear air conduction hearing level, AUPB2A6 8000 Hz (dB) 6194 -10-105 272 888 Blank but applicable 24845 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ RIGHT EAR TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3117-3119 Right ear air conduction hearing level, AUPB2A7 repeat test at 1000 Hz (dB) 6193 -10-105 273 888 Blank but applicable 24845 Blank 3120-3122 Right ear air conduction hearing level, AUPB2A8 500 Hz (dB) 6192 -10-105 274 888 Blank but applicable 24845 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ RETEST RESULTS WITH MASKING ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3123-3126 Audiometer number for retest See note AUPAUDO2 9 1230 16 1237 14 1240 30 1580 5 1581 13 2048 22 2050 31202 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ LEFT EAR RETEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3127-3129 Left ear air conduction retest hearing See note AUPB1C1 level, first retest at 1000 Hz (dB) 18 015-105 1 888 Blank but applicable 31292 Blank 3130-3132 Left ear air conduction retest hearing See note AUPB1C2 level, 2000 Hz (dB) 16 020-105 1 888 Blank but applicable 31294 Blank 3133-3135 Left ear air conduction retest hearing See note AUPB1C3 level, 3000 Hz (dB) 17 020-105 1 888 Blank but applicable 31293 Blank 3136-3138 Left ear air conduction retest hearing See note AUPB1C4 level, 4000 Hz (dB) 22 035-105 1 888 Blank but applicable 31288 Blank 3139-3141 Left ear air conduction retest hearing See note AUPB1C5 level, 6000 Hz (dB) 22 035-100 1 888 Blank but applicable 31288 Blank 3142-3144 Left ear air conduction retest hearing See note AUPB1C6 level, 8000 Hz (dB) 27 000-100 1 888 Blank but applicable 31283 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ LEFT EAR RETEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3145-3147 Left ear air conduction retest hearing See note AUPB1C7 level, repeat retest at 1000 Hz (dB) 18 025-105 1 888 Blank but applicable 31292 Blank 3148-3150 Left ear air conduction retest hearing See note AUPB1C8 level, 500 Hz (dB) 14 030-105 1 888 Blank but applicable 31296 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ RIGHT EAR RETEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3151-3153 Right ear air conduction retest hearing See note AUPB2C1 level, first retest at 1000 Hz (dB) 13 030-100 1 888 Blank but applicable 31297 Blank 3154-3156 Right ear air conduction retest hearing See note AUPB2C2 level, 2000 Hz (dB) 16 025-105 1 888 Blank but applicable 31294 Blank 3157-3159 Right ear air conduction retest hearing See note AUPB2C3 level, 3000 Hz (dB) 20 010-105 1 888 Blank but applicable 31290 Blank 3160-3162 Right ear air conduction retest hearing See note AUPB2C4 level, 4000 Hz (dB) 28 025-105 31283 Blank 3163-3165 Right ear air conduction retest hearing See note AUPB2C5 level, 6000 Hz (dB) 29 000-105 1 888 Blank but applicable 31281 Blank 3166-3168 Right ear air conduction retest hearing See note AUPB2C6 level, 8000 Hz (dB) 31 015-105 1 888 Blank but applicable 31279 Blank 3169-3171 Right ear air conduction retest hearing See note AUPB2C7 level, repeat retest at 1000 Hz (dB) 13 030-105 1 888 Blank but applicable 31297 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ RIGHT EAR RETEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3172-3174 Right ear air conduction retest hearing See note AUPB2C8 level, 500 Hz (dB) 16 025-100 1 888 Blank but applicable 31294 Blank NHANES III Examination Data File ------------------------------------------------------------------------ AUDIOMETRY ------------------------------------------------------------------------ GENERAL INFORMATION ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3175-3179 Examiner number AUPTECH 6274 01001-09018 223 88888 Blank but applicable 24814 Blank NHANES III Examination Data File ------------------------------------------------------------------------ THIS PAGE INTENTIONALLY LEFT BLANK NOTES AUPA10: Drainage/discharge from either ear? Examinees who reported having ear drainage were excluded from air conduction testing on the ear with drainage and from tympanic membrane compliance testing on both ears. Threshold value fields for excluded ears are blank. Tympanometry data fields for excluded examinees are blank. AUPA9: Tube in right or left ear? Examinees who reported having a tube in either or both ears were excluded from tympanic membrane compliance testing. However, air conduction threshold testing was performed if there was no report or evidence of drainage (AUPA10). Tympanometry data fields for excluded examinees are blank. AUPAUDO2 and AUPB1C1-AUPB1C8, AUPB2C1-AUPB2C8: Retest information When examinees had air conduction threshold values at a given frequency that differed by 40 dB or more between the left and right ears, the ear with the higher threshold value(s) was retested while a masking sound was introduced into the other ear. In cases for which a retest was indicated but for which no retest data existed, the relevant variables were coded "Blank but applicable." If no threshold value differences of 40 dB or more